Method and apparatus for providing information related to labor progress for an obstetrics patient

ABSTRACT

A method and apparatus for evaluating labor progress during childbirth for an obstetrics patient are provided. A set of information data elements associated to an obstetrics patient are received, the set of information data elements including a cervical dilation measure and a level of descent indicator. The set of information data elements is processed to generate labor progress information associated to the obstetrics patient. The labor progress information conveys whether the level of descent indicator is within an expected range of levels of descent corresponding to the cervical dilation measure. A signal for causing the labor progress information to be provided to a user is then released.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.11/330,942 filed Jan. 12, 2006, which in turn claims the benefit ofpriority on the previously filed U.S. provisional application entitled“Method and apparatus for providing information related to laborprogress for an obstetrics patient” filed on Jun. 7, 2005 by EmilyHamilton and which was assigned Ser. No. 60/687,855. The contents of theabove applications are incorporated herein by reference.

FIELD OF THE INVENTION

The present invention relates generally to the field of obstetrics, andmore specifically to a method and apparatus for providing informationrelated to labor progress for an obstetrics patient. This invention canbe used to assist decision making in clinical medicine.

BACKGROUND OF THE INVENTION

The labor of childbirth is the process by which uterine contractionscause the fetus and placenta to be expelled from the uterus and birthcanal. Rhythmic contractions of the uterine muscle create a force thatpushes the fetus against the opening of the uterus, commonly referred toas the cervix. The cervix is a tubular structure that is firm and closedduring pregnancy, keeping the baby and membranes protected inside theuterus. At term, the cervix softens and in labor the continuing pressureof the fetus on the cervix causes it to shorten (efface) and to open(dilate) up to 10 centimeters. As the cervix completely effaces anddilates, the contractions and the mother push the baby through the birthcanal. The level of descent of the baby through this passage is referredto as station. Contractions are the forces that promote cervicaldilation. Resistance of the cervix and the birth canal are the opposingforces to the contractions. In addition, the resistance of the cervixchanges as it becomes more effaced and more dilated.

Commonly, the effacement, the dilation, the frequency and strength ofthe contractions and the station are measured clinically during laborand are used by the doctors to determine if the labor is progressingnormally. Generally, if the doctor determines that the labor isprogressing normally, the delivery is permitted to continue through thebirth canal. However, if the doctor determines that the labor is notprogressing normally, a cesarean section is effected to complete thedelivery. Cesarean deliveries are associated with maternal morbidity andan increase in the risk of complications during the current and thesubsequent pregnancies. Cesarean deliveries are also more expensive thanvaginal births.

Due to the very large number of possible combinations of values for thedilation, the effacement, the frequency of the contractions and thestation, the evaluation of labor progress is a difficult task fordoctors. Unlike most surgical procedures, there is no suitablepostoperative confirmation of the preoperative diagnosis that can beused to validate the doctor's decision.

One of the most commonly used guidelines for assessing the progress oflabor during the first stage of labor is to evaluate the level ofdescent of the baby, or station, with respect to time. Intuitively, ifthe level of descent of the baby does not progress as time goes by,there may be cause for concern. Another guideline is to observe thedilation of the cervix during the first stage of labor with respect totime. Similarly, if dilation of the cervix does not progress as timegoes by, there may also be cause for concern. For more informationregarding the above, the reader is invited to refer to J. Zhang et al.,“Reassessing the labor curve in nulliparous women”, Transactions of thetwenty-second annual meeting of the society for maternal-fetal medicine,American Journal of Obstetrics and Gynecology, Volume 187, Number 4,October 2002, pp. 824-828. The contents of the above document areincorporated herein by reference.

A deficiency associated with existing methods, such as the onesdescribed in the above noted publication, is that they do not adequatelyquantify labor progression. It will be appreciated that certain womentake 4 hours to complete the first stage of labor while other women take24 hours or more to complete the first stage. The above guidelinesprovide a general description of the average and range of observed ratesof change in cervical dilation and fetal descent over time. These ratesreflect an average response to an average set of conditions. They do notprovide a method for discriminating if the unusually slow progression isdue to conditions such as poor uterine contraction strength, or highcervical compliance or to a misfit between the size of the baby and thesize of the mother. In practice, the clinical staff relies to a greatextent on its knowledge and experience, rather than on such absolutemeasurements in order to make decisions as to whether an interventionshould be considered. While doctors and nurses are trained andpresumably competent in their ability to assess labor progression, therecan be differences of interpretation that may result in either delayedor excessive rates of intervention depending upon the caregivers. Assuch, due to the lack of objective and reliable data, variations injudgment or management are more prone to occur; the more extreme causingharm to mother and or baby. Further, in the absence of such objectiveand reliable data and when the actions of the health care team areevaluated retrospectively, the reviewers who may be judges and jurorsmust also make subjective interpretations about the adequacy of thelabor progression and the reasonableness of the clinical opinions at thetime. The current methods do not provide a suitable indication of normaland abnormal labor progress, which considers specific and changeablelabor conditions.

Therefore, in the context of the above, there is a need to provide amethod and apparatus for providing information related to labor progressfor an obstetrics patient that alleviates at least in part problemsassociated with the existing methods and devices.

SUMMARY OF THE INVENTION

In accordance with a broad aspect, the present invention provides amethod for evaluating labor progress during childbirth for an obstetricspatient. The method comprises receiving a set of information dataelements associated to an obstetrics patient including a cervicaldilation measure and a level of descent indicator. The method alsoincludes processing the set of information data elements to generatelabor progress information associated to the obstetrics patient. Thelabor progress information conveys whether the level of descentindicator is within an expected range of levels of descent correspondingto the received cervical dilation measure. The method also includescausing the labor progress information to be provided to a user.

In a specific example of implementation, the labor progress informationconveys the level of descent indicator in relation to the expected rangeof levels of descent.

In a first specific example of implementation, the cervical dilationmeasure is an expected cervical dilation measure associated to theobstetrics patient. The expected range of levels of descent is derivedat least in part on the basis of the expected cervical dilation measure.The labor progress information is caused to be conveyed in eithergraphical format or text format.

In a specific implementation where the labor progress information iscaused to be conveyed in graphical format, the graphical format includesa chart having a horizontal axis and a vertical axis, the horizontalaxis being associated to time and the vertical axis being associated tolevels of descent.

In a second specific example of implementation, the cervical dilationmeasure is an observed cervical dilation measure associated to theobstetrics patient. The observed cervical dilation measure is obtainedduring a conventional cervical examination. The expected range of levelsof descent is derived at least in part on the basis of the observedcervical dilation measure. The method also includes providing aplurality of expected ranges of levels of descent, each expected rangeof levels of descent corresponding to a respective cervical dilation andcausing the plurality of expected ranges of levels of descent to beconveyed to a user. In a specific implementation, the plurality ofexpected ranges of levels of descent is derived from data associated toa reference population. The labor progress information is caused to beconveyed in either text format or graphical format. In a specificimplementation where the labor progress information is caused to beconveyed in graphical format, the graphical format includes a charthaving a horizontal axis and a vertical axis, the horizontal axis beingassociated to cervical dilation measures and the vertical axis beingassociated to levels of descent.

In specific implementations, the labor progress information may beconveyed on a display screen or may be presented in printed format.

In a specific example of implementation, the method further includesgenerating intervention policy information when the level of descentindicator is outside the expected range of levels of descent and causingthe intervention policy information to be provided to a user. In anon-limiting example of implementation, the intervention policyinformation may indicate that a cesarean section is recommended when thelevel of descent indicator is outside the expected range of levels. Thepossible intervention policy information may include, without beinglimited to medications to increase uterine contractions, maternalpositional changes to promote rotation and descent of the baby's head orcesarean section.

In accordance with another broad aspect, the present invention providesan apparatus for evaluating labor progress during childbirth for anobstetrics patient in accordance with the above-described method.

In accordance with yet another broad aspect, the present inventionprovides a computer readable storage medium including a program elementsuitable for execution by a computing apparatus. The computing apparatushas a memory unit and a processor in communication with the memory unitfor evaluating labor progress during childbirth for an obstetricspatient in accordance with the above-described method.

In accordance with yet another broad aspect, the present inventionprovides a system for monitoring an obstetrics patient. The systemcomprises an interface for receiving a set of information data elementsassociated to an obstetrics patient, the set of information dataelements including a cervical dilation measure and a level of descentindicator. The system further comprises an apparatus for generatinglabor progress information in accordance with the above-describedmethod, the apparatus being in communication with the interface. Thesystem further comprises an output unit in communication with theapparatus for conveying the labor progress information to a user.

In specific examples of implementation, the interface may be anysuitable input device for receiving a set of information data elementsassociated to an obstetrics patient, such as, but not limited to akeyboard, a pointing device, a touch sensitive screen, and a voicerecognition unit.

In specific examples of implementation, the output unit may be anysuitable output device for providing labor progress information to auser, such as, but not limited to a display screen and a printingdevice.

In accordance with yet another broad aspect, the present inventionprovides a client-server system for evaluating labor progress duringchildbirth for an obstetrics patient. The client-server system includesa client system and a server system operative to exchange messages overa data network. The server system stores a program element for executionby a CPU and including first, second, third and fourth program elementcomponents. The first program element component is executed on theserver and is for receiving a set of information data elementsassociated to an obstetrics patient, the set of information dataelements including a cervical dilation measure and a level of descentindicator. The second program element component is executed on theserver system and is for processing the set of information data elementsto generate labor progress information associated to the obstetricspatient. The labor progress information conveys whether the level ofdescent indicator is within an expected range of levels of descent, theexpected range of levels of descent corresponding to the cervicaldilation measure. The third program element component is executed on theserver system and is for sending messages to the client system forcausing the client system to convey the labor progress information. Thefourth program element component is executed on the client server systemand is for receiving a message from the server system for conveying thelabor progress information to a user.

In accordance with another broad aspect, the invention provides a methodfor evaluating labor progress during childbirth for an obstetricspatient. The method includes obtaining a set of information dataelements associated to an obstetrics patient, the set of informationdata elements including a cervical dilation measure and a level ofdescent indicator. The method also includes transmitting the set ofinformation data elements to a remote computing apparatus, the remotecomputing apparatus being operative for generating labor progressinformation associated to the obstetrics patient. The labor progressinformation conveys whether the level of descent indicator is within anexpected range of levels of descent, where the expected range of levelsof descent corresponds to the cervical dilation measure. The method alsoincludes receiving data from the remote computing apparatus, the dataconveying the labor progress information and causing the labor progressinformation to be provided to a user.

These and other aspects and features of the present invention will nowbecome apparent to those of ordinary skill in the art upon review of thefollowing description of specific embodiments of the invention inconjunction with the accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

In the accompanying drawings:

FIG. 1 shows a high-level functional block diagram of a system formonitoring an obstetrics patient in accordance with a specific exampleof implementation of the present invention;

FIG. 2 is a diagram illustrating the use of stations as a measure of thelevel of descent in accordance with a specific example of implementationof the invention;

FIG. 3 shows a user interface, in accordance with a non-limiting exampleof implementation of the present invention for use in the apparatusshown in FIG. 1, for receiving a set of information data elementsassociated to an obstetrics patient;

FIG. 4 shows a functional block diagram of an apparatus for generatinglabor progress information suitable for use in the system depicted inFIG. 1 in accordance with a first specific example of implementation ofthe present invention;

FIG. 5 is a flow diagram of a process in accordance with a specificexample of implementation of the present invention for generating laborprogress information conveying whether the level of descent associatedto an obstetrics patient is within an expected range of levels ofdescent;

FIG. 6 a shows a station curve conveying expected ranges of station(level of descent) versus cervical dilations in accordance with aspecific example of implementation of the present invention;

FIG. 6 b shows a station curve conveying expected ranges of station(level of descent) versus time in accordance with another specificexample of implementation of the present invention;

FIG. 7 a shows a first non-limiting example of a normogram of stations(levels of descent) derived on the basis of actual observations in areference populations in accordance with a specific example ofimplementation of the present invention;

FIG. 7 b shows a second non-limiting example of a normogram of stations(levels of descent) in accordance with a specific example ofimplementation of the present invention;

FIG. 7 c is a graph depicting the average values for the standarddeviation of stations based on observations and the correspondingmathematical model for the standard deviation of the stations inaccordance with a specific example of implementation of the presentinvention;

FIG. 8 shows an example of a graphical user interface including a visualrepresentation of the data released by the processing unit shown in FIG.1 in accordance with a specific example of implementation of the presentinvention;

FIG. 9 shows a functional block diagram of an apparatus for generatinglabor progress information suitable for use in the system depicted inFIG. 1 in accordance with a second specific example of implementation ofthe present invention;

FIGS. 10 a and 10 b show examples of visual representations of the datareleased by the apparatus for generating labor progress informationshown in FIG. 9 in accordance with a specific example of implementationof the present invention;

FIG. 11 shows a functional block diagram of an apparatus for generatinglabor progress information associated to an obstetrics patient inaccordance with another specific example of implementation of thepresent invention;

FIG. 12 shows a functional block diagram of a client-server system forgenerating labor progress information associated to an obstetricspatient in accordance with an alternative specific example ofimplementation of the present invention;

FIG. 13 is a conceptual representation of a computer readable storagemedium storing a program element suitable for use in connection with theclient-server system shown in FIG. 12 for generating labor progressinformation associated to an obstetrics patient in accordance withanother specific example of implementation of the present invention.

Other aspects and features of the present invention will become apparentto those ordinarily skilled in the art upon review of the followingdescription of specific embodiments of the invention in conjunction withthe accompanying figures.

DETAILED DESCRIPTION

With reference to FIG. 1, there is shown a configuration of a system 100for monitoring an obstetrics patient. The system 100 comprises a userinterface 102, an apparatus 101 including a processing unit 104, and anoutput unit 106.

The user interface 102 includes any one or a combination of a keyboard,a pointing device, a touch sensitive surface, a speech recognition unitor any other suitable device allowing information to be entered by auser. Alternatively, the user interface 102 may be in the form of a datainput device such as, but not limited to, a disk drive, CD-ROM, a portconnected to a data stream and flash memory. The user interface 102enables a user to provide a set of information data elements associatedto a certain obstetrics patient.

The set of information data elements includes a cervical dilationmeasure and a level of descent indicator. In a non-limiting example ofimplementation, the level of descent indicator is expressed as astation. Station refers to a measure in centimetres of the distancebetween the leading bony edge of the presenting fetal part and thematernal ischial spines, which are palpable prominences on one of thebony borders of the birth canal. The clinician can feel these landmarksduring a pelvic examination and thereby estimates this distance. Whenthe fetal part is above the spines the notation is negative, when at thespines the notation is 0, and when the baby is lower or closer to beingborn the notation is positive. FIG. 2 of the drawings illustrates theuse of stations as a measure of the level of descent. It will beappreciated that manners for expressing the level of descent of a fetusother than the use of stations may be used without detracting from thespirit of the invention.

FIG. 3 of the drawings depicts a non-limiting example of a userinterface for receiving a set of information data elements associated toa certain obstetrics patient. In the specific example depicted, the setof information data elements includes a previous vaginal birth indicator(nulliparous or multiparous patient) 304 and a plurality of level ofdescent indicator/cervical dilation measure pairs 300A-D, each pair300A-D being indicative of measurements taken at a given time during thefirst stage of labor.

Optionally, the set of information data elements also includes, withoutbeing limited to, information derived from a maternal age component, agestational age indicator, and maternal race. Optionally still, the setof information data elements may include information derived from laborinformation elements. Examples of labor information elements include,without being limited to, induction of labor and epidural anaesthesia.Other suitable information data elements may also be provided throughuser interface 102 without detracting from the spirit of the invention.

The apparatus 101 receives the set of information data elementsincluding the cervical dilation measure and the level of descentindicator. The apparatus 101 processes the set of information dataelements to generate labor progress information associated to theobstetrics patient. In the specific embodiment shown in FIG. 1,apparatus 101 includes a processing unit 104, an input 110 and an output114. Input 110 is operative for receiving signals from the userinterface 102 indicative of a set of information data elementsassociated to the obstetrics patient. As shown in FIG. 1, the processingunit 104 is in communication with input 110 for receiving the signal orsignals indicative of a set of information data elements associated tothe obstetrics patient. As will be described in more detail below, onthe basis of the signal or signals received at input 110, the processingunit 104 is operative to generate labor progress information associatedto the obstetrics patient. The labor progress information conveyswhether the level of descent indicator is within the expected range oflevels of descent corresponding to the cervical dilation measure.

The apparatus 101 releases at output 114 a signal for causing outputunit 106 to convey the labor progress information to a user. The outputunit 106 may be in the form of any suitable device for conveyinginformation to the physician or other health care professional. In aspecific example of implementation, the output unit 106 can include adisplay screen, or in an alternative example of implementation, theoutput unit 106 can include a printing device for displaying the data inprinted form.

In a specific example, the system 100 is used during the first stage oflabor to monitor whether the level of descent of the fetus is within anexpected range of levels of descent for a given cervical dilation.Multiple measurements of the level of descent and of the cervicaldilation are obtained from an obstetrics patient over time to track theprogression of the level of descent against the cervical dilation. Thisinformation is presented to the health care practitioner in graphicalformat or in text format. This information may be used in combinationwith a hospital policy, to assist a physician in determining whether thelabor of a given obstetric patient is progressing normally or whetherintervention is advisable.

Alternatively, in a second specific implementation, the system 100 maybe used after a delivery to assess whether the progression of the levelsof descent against the cervical dilations was within expected ranges oflevels of descent during the first stage of labor. In a manner similarto that in the first implementation, multiple measurements of the levelof descent and of the cervical dilation are obtained from a recordassociated to an obstetrics patient to track over time the progressionof the level of descent against the cervical dilation. Such informationmay be useful in the context of an insurance claim, a legal malpracticesuit or another situation in which a physician's actions or decisionsare being questioned. For example, this information may be used incombination with other data to determine whether a physician respectedcertain intervention policies and best practice guidelines.

The processing unit 104 in apparatus 101 will now be described ingreater detail below with reference to FIG. 4 in a first embodiment andwith reference to FIG. 9 in a second embodiment.

Processing Unit 104 First Embodiment

In a first specific embodiment, the processing unit 104 is adapted toderive an expected range of levels of descent at least in part on thebasis of a cervical dilation measure, the cervical dilation measurebeing an observed cervical dilation measure. The observed cervicaldilation measure is obtained from a pelvic examination.

As shown in FIG. 4, the processing unit 104, in accordance with a firstspecific embodiment, includes a labor progress generation module 210, amemory unit 220 and an output control module 240.

Memory unit 220 stores a plurality of expected ranges of levels ofdescent, each expected range of levels of descent corresponding to arespective cervical dilation. In a specific implementation, theplurality of expected ranges of levels of descent corresponding torespective cervical dilations are stored in the form of a normogram ofstations conveying for each cervical dilation a mean expected level ofdescent and a standard deviation of the level of descent. The manner inwhich the normogram is derived will be described later on in thespecification. Alternatively, memory unit 220 stores a mathematicalmodel allowing to compute a plurality of expected ranges of levels ofdescent on the basis of a cervical dilation.

Optionally, memory unit 220 stores multiple sets of mappings between thecervical dilations and the expected range of levels of descent, each setof mappings being associated to mothers having certain characteristics.In a specific example, memory unit 220 stores one set of mappingsbetween the cervical dilations and the expected range of levels ofdescent for nulliparous women and another set of mappings formultiparous women.

It will be appreciated that although memory unit 220 has been shown tobe an integral parts of processing unit 104, memory unit 220 may be anexternal component to processing unit 104 without detracting from thespirit of the invention.

Labor Progress Information Generation Unit 210

For an observed level of descent indicator/cervical dilation pairreceived at input 110, the labor progress generation module 210 isadapted to generate data conveying whether the observed level of descentindicator is within the expected range of levels of descentcorresponding to the observed cervical dilation. The expected range oflevels of descent corresponding to the cervical dilation is derived frominformation stored in memory unit 220.

FIG. 5 of the drawings depicts a process implemented by the laborprogress generation module 210 in accordance with a specific example ofimplementation of the invention.

At step 400, patient data is received by the labor progress generationmodule 210. The patient data includes a set of information data elementsassociated to an obstetrics patient including a cervical dilationmeasure and an observed level of descent indicator. Optionally, thepatient data may also include, without being limited to, a previousvaginal birth indicator (nulliparous or multiparous patient), whether ornot an epidural was given, maternal age component, a maternal diabetesindicator, gestational age indicator, maternal weight, maternal heightand maternal race.

At step 410, in the specific example of implementation where the memoryunit 220 includes multiple sets of mappings between the cervicaldilations and the expected range of levels of descent, the laborprogress generation module 210 selects a set of mappings on the basiscertain patient characteristics (previous vaginal birth indicator(nulliparous or multiparous patient), whether or not an epidural wasgiven, maternal age component, a maternal diabetes indicator,gestational age indicator, maternal weight, maternal height and maternalrace). It will be appreciated that, in implementations where the mappingbetween the cervical dilations and the expected range of levels ofdescent is not differentiated on the basis of patient characteristics,step 410 may be omitted.

At step 420, the labor progress generation module 210 makes use of theinformation in memory unit 220 and the set of information data elementsreceived in order to generate labor progress information. The laborprogress information conveys whether the observed level of descentindicator is within the expected range of levels of descent for theobserved cervical dilation measure. The expected range of levels ofdescent for the observed cervical dilation measure is obtained from thememory unit 220.

Optionally, the labor progress information conveys multiple observationstaken over time of levels of descent and cervical dilation measures suchas to convey for each of the levels of descent whether it was within theexpected range of levels of descent for the corresponding cervicaldilation measure. By taking these measures over time, the labor progressinformation also conveys the trend of the levels of descent with respectto the cervical dilations.

Optionally still, the labor progress information conveys a divergencebetween the observed level of descent and the expected range of levelsof descent. More specifically, the labor progress generation module 210is adapted for computing the divergence between the observed level ofdescent and the mean expected level of descent for a given cervicaldilation and for conveying this divergence to the user. The divergenceof the observed level of descent from the mean expected level of descentmay be expressed in absolute terms or in terms of a ranking.

As a first example using the divergence expressed in absolute terms,take a mean expected level of descent for a 3 cm dilation to be −1.7 andthe observed level of descent to be −1.0, then the divergence isexpressed in absolute terms as:

Observed−expected=observed divergence

−1.0−(−1.7)=+0.7

The above divergence of +0.7 indicates that the descent is progressingfaster that the mean. It will be apparent however that this value doesnot necessarily convey sufficient information to a physician withoutalso providing what the spread or standard deviation of the expectedlevel of descent as observed in a reference population.

As a second example, take a mean expected level of descent for a 3 cmdilation to be −1.7, a standard deviation of 0.9 and the observed levelof descent to be −1.0. Using the standard deviation of the expectedlevel of descent, the percentile ranking of the observed level ofdescent can be computed.

Optionally still, the labor progress generation module 210 is furtheradapted for generating intervention policy information when the level ofdescent indicator is outside the expected range of levels of descent.The policy is generally determined by a health care institution orprofessional association, usually a hospital, which determines a certainlevel of care. In a non-limiting example of implementation, theintervention policy information may indicate that a cesarean section isrecommended when the level of descent indicator is outside the expectedrange of levels. The possible intervention policy information mayinclude, without being limited to, instructions to perform or to avoidrupturing the membranes, medications to increase uterine contractions,maternal positional changes to promote rotation of the baby's head orcesarean section.

At step 430, the labor progress information, and optionally theintervention policy information, are released to the output controlmodule 240 and conveyed to a user.

In a first specific example of implementation, the labor progressgeneration module 210 is adapted to generate data for causing laborprogress information to be conveyed in graphical format.

FIG. 6 a of the drawings shows a specific example of labor progressinformation conveyed in graphical format in accordance with a specificexample of implementation. In the chart 720 depicted in FIG. 6 a,horizontal axis 712 is associated to cervical dilation measures andvertical axis 714 is associated to levels of descent, in this exampleexpressed in the form of stations. The observed levels of descent atgiven cervical dilations associated to the obstetrics patient areplotted on the chart 720 as items 706 708 and 710. Optionally, thedifferent items 706 708 and 710 are connected to one another with acurve such as to visually show the progression of the levels of descent.The chart 720 also shows the expected ranges of levels of descentcorresponding to cervical dilations that are derived from informationstored in memory unit 220. More specifically, curves defining an upperboundary 700 and a lower boundary 704 convey the ranges of expectedlevels of descent for various cervical dilations. Optionally, the meanvalue of the level of descent is also shown in the chart 720 as a curve702.

Advantageously, the information conveyed by the above-described chartcan be used by a physician or other health care practitioner to assesswhether the baby is descending through the birth canal normally duringlabor. The curves defining the upper boundary 700 and the lower boundary704 convey the ranges of expected levels of descent for various cervicaldilations during normal labors. As will be described later on in thespecification, the upper boundary 700 and lower boundary 704 may be setaccording to various factors. In a non-limiting implementation, theupper boundary 700 and lower boundary 704 are set to correspond to the95^(th) and 5^(th) percentile of a normal distribution of levels ofdescent for a each increment of cervical dilation as observed in areference population. The physician can compare visually a mother'sobserved level of descent to the range of expected ones for a cervicaldilation value.

FIG. 6 b of the drawings shows an alternative specific example of laborprogress information conveyed in graphical format in accordance withanother specific example of implementation. In the chart 10 depicted inFIG. 6 b, horizontal axis 12 is associated to time and vertical axis 14is associated to levels of descent, in this example expressed in theform of stations. The observed levels of descent at given times isplotted on the chart 10. The chart 10 also shows the expected ranges oflevels of descent corresponding to the different times that are derivedfrom information stored in memory unit 220. More specifically, curvesdefining an upper boundary 2 and a lower boundary 4 convey the ranges ofexpected levels of descent at various times. Optionally, the mean valueof the level of descent is also shown in the chart 10 as a curve 3. Ateach time interval, the expected range of levels of descent is computedon the basis of the observed cervical dilation at that time using theinformation stored in memory unit 220.

In a second specific example of implementation, the labor progressgeneration module 210 is adapted to generate data for causing laborprogress information to be conveyed in text format to a user. Anysuitable representation for conveying the observed level of descentindicator in relation to the expected range of levels of descent may beused. In a non-limiting example, this information is represented in theform of a table conveying an observed level of descent in relation tothe expected range of levels of descent for a cervical dilation measure.

Observed Cervical Expected level of descent Observed level of descentdilation (station) (station) 0 cm Average: −2.23 −2 Range: −0.10 to−4.35 1 cm Average: −2.03 No measure taken Range: −0.40 to −3.66 2 cmAverage: −1.85 −1.5 Range: −0.42 to −3.28 3 cm Average: −1.67 −1.3Range: −0.24 to −3.11 4 cm . . . 5 cm . . . . . . . . .

It will be appreciated that other suitable manners for conveying anobserved level of descent in relation to an expected range of levels ofdescent for a cervical dilation measure in a text format may be usedwithout detracting from the spirit of the invention.

Advantageously, the information in the above-described table can be usedby a physician or other health care practitioner to assess whether thebaby is descending properly during labor.

Optionally, the above-described process and system can be used incombination with a system allowing assessing the progression of thecervical dilation during labor.

FIG. 8 shows a non-limiting example of a specific visual representationcaused to be displayed by output unit 106 when the system 100 depictedin FIG. 1 is used in combination with a system depicting the progress ofthe cervical dilation. This visual representation includes a first chart600 conveying the observed levels of descent 602 604 606 608 withrespect to expected ranges of levels of descent derived in accordancewith the method described above. The specific visual representationshown in FIG. 6 also includes a second chart 612 conveys the progressionof the cervical dilation during labor over time. In addition to, orinstead of, chart 600, the specific visual representation includes chart650 conveying the observed levels of descent 602 604 605 606 608 withrespect to expected ranges of levels of descent plotted against the timeaxis. The expected ranges of levels of descent are derived on the basisof the observed cervical dilation depicted in chart 612. Optionally, thetime axis of charts 612 and 650 are aligned with one another such as toallow a user to readily view the observed cervical dilationsimultaneously with the observed level of descent against the expectedthe expected range of levels of descent at a given time.

By providing the physician with information related to the progressionof the cervical dilation as well as with information regarding how thedescent of the baby is progressing with respect to the cervicaldilation, an improved assessment of labor progression can be provided tothe physician or health care practitioner.

Optionally, as shown in the example depicted in FIG. 8, a recommendationcomponent 610 is also displayed. The recommendation component providesan interpretation of the information displayed in charts 600 and 612 aswell as a recommended course of action.

It will be appreciated that the specific visual representation shown inFIG. 8 has been provided for the purpose of illustration only and thatother visual representations are possible, including additional items ofinformation or omitting certain items of information, without detractingfrom the spirit of the invention.

Output Control Module 240

With reference to FIG. 4, the output control module 240 receives thelabor progress information, and optionally the intervention policyinformation, and generates a signal to be released at output 114 forcausing output unit 106 to convey information to a user. The outputcontrol module 240 will typically include components such as displaydrivers, printer drivers and user interface software components amongstothers.

In a non-limiting implementation, the output control module 240 isadapted for generating a visual representation of the labor progressinformation in the form of a graphical window that could be shown on thedisplay screen of a computer, PDA or other suitable device.Alternatively, the visual representation may be in the form of aprintout. Optionally, the output control module 240 is further adaptedfor displaying the intervention policy information in a graphicalformat, or by using a coded colour scheme, or other display convention.

The specific manner in which the output control module 240 isimplemented is not critical to the invention and as such will not bedescribed further here.

Memory Unit 220

The content of memory unit 220 and the manner in which such content canbe generated will now be described.

The memory unit 220 includes information conveying a plurality ofexpected ranges of levels of descent, each expected range of levels ofdescent corresponding to a respective cervical dilation. In a specificexample of implementation, the mapping between the cervical dilationsand the expected range of levels of descent is derived on the basis ofactual clinical measurements taken from patients in the first stage oflabor.

The information in memory unit 220 may be stored in any suitable format.In a first specific implementation, the information in memory unit 220is stored as a table mapping cervical dilations to correspondingexpected ranges of levels of descent. A specific example of such a tableis illustrated below. In the table below, for each 1 cm increment ofcervical dilation, a lower limit of the range of expected levels ofdescent and an upper limit of the range of expected levels of descentare provided as well as a mean value of the expected level of descent.

TABLE 1 Expected Level of Descent (Station) Cervical 95th 5th 10-thDilatation average centile centile 90th centile centile StdDev 0 −2.23−4.35 −0.10 −3.88 −0.57 1.29 1 −2.03 −3.66 −0.40 −3.30 −0.76 0.99 2−1.85 −3.28 −0.42 −2.96 −0.73 0.87 3 −1.67 −3.11 −0.24 −2.79 −0.55 0.874 −1.37 −2.86 0.12 −2.53 −0.21 0.90 5 −1.08 −2.58 0.42 −2.25 0.09 0.91 6−0.81 −2.33 0.71 −2.00 0.37 0.92 7 −0.54 −2.25 1.17 −1.88 0.79 1.04 8−0.28 −2.04 1.47 −1.65 1.09 1.07 9 0.02 −1.90 1.94 −1.48 1.51 1.17 100.66 −1.59 2.91 −1.09 2.42 1.37

It is to be appreciated that the values listed above are presented forthe purpose of illustration only. Specific implementations of theinvention may make use of values differing from the above withoutdetracting from the spirit of the invention.

The mapping of the cervical dilations and the expected range of levelsof descent may be derived in a number of manners. Below two differentspecific examples of methods for deriving the mapping are described. Thefirst method is based on actual observations of the mean expected valueof the level of descent and the standard deviation of the levels ofdescent. The second method is based on a mathematical model including:

-   -   1. A first mathematical equation describing a mapping between        the mean expected value of the level of descent and the cervical        dilation; and    -   2. A second mathematical equation describing a mapping between        the standard deviation of the levels of descent and the levels        of descent.

First Method

In a specific implementation, a range of expected levels of descent foreach cervical dilation is derived on the basis of statisticalobservations obtained from a reference population. The table below showsin a summarized form the basic data used for deriving a mapping of levelof descent versus dilatation. The numerical values presented below wereobtained for nullipara women. It will be readily appreciated thatsimilar data may be obtained for multipara women. Alternatively, a sameset of data may be used for all women irrespective of whether they arenulliparous or multiparous.

TABLE 2 no. of average Dilatation observations stn StdDev 0 252 −2.2 1.31 952 −2.0 1.0 2 1158 −1.8 0.9 3 2930 −1.7 0.9 4 2507 −1.4 0.9 5 1554−1.1 0.9 6 1208 −0.8 0.9 7 928 −0.5 1.0 8 963 −0.3 1.1 9 1416 0.0 1.2 103037 0.7 1.4

The above table includes, for each 1 cm increment of cervical dilation,the average of the observed levels of descent and the standard deviationof the observed levels of descent. By knowing the average level ofdescent and the distribution of values around the average level ofdescent, a relationship between a cervical dilation and a range oflevels of descent can be constructed. For example, the outer limits ofthe range of levels of descent for each cervical dilation can be set tocorrespond to certain desired percentiles using the standard deviation.In a non-limiting example of implementation, the assumption that theobservations of the levels of descent exhibit a generally normaldistribution has been made. The person skilled in the art willappreciate that the distribution of values around the average level ofdescent may exhibit other types of distribution than the normaldistribution without detracting from the spirit of the invention.

FIG. 7 a of the drawings is a graph depicting a mapping between thecervical dilations and expected ranges of levels of descent. In thefigure shown, the ranges are defined by the outer limits correspondingto the 5^(th), 10^(th), 90^(th) and 95^(th) percentiles.

Second Method

In an alternative specific implementation, a mathematical model is usedto derive a range of expected levels of descent for each cervicaldilation. Many possible mathematical functions can be used to providethis mapping. In a non-limiting implementation, a first mathematicalequation is used for deriving the mean expected level of descent for agiven cervical dilation and a second mathematical model is used forderiving the standard deviation for the expected level of descent foreach cervical dilation.

These mathematical equations may be derived using well-known statisticalmethods. In a non-limiting implementation, as a first step, well-knownstatistical methods are applied to the data shown in table 2 above inorder to derive a curve that will fit the data describing therelationship between the average level of descent and the cervicaldilation. Such statistical methods include, without being limited to,linear regression, polynomial approximation and any other mathematicalmethod suitable for deriving a mathematical relationship between twovariables. The specific mathematical equation below was derived byfitting a curve to the data of the average level of descent v. cervicaldilation shown in table 2 above:

y=−0.012x ²+−0.1537x−2.2064

R²=0.9944

In the above equation, y is the expected average (mean) level ofdescent, x is the cervical dilation and R² is the correlationcoefficient squared which is a measure of how well the fit is betweenthe curve defined by the mathematical equation and the actual observeddata set out in the table above. As will be appreciated by the personskilled in the art, the closer R² is to “1” the better the fit of themathematical model to the actual observations. In biological systems, anR² greater than about 0.65 is generally considered to be a good fit. Theabove-described equation provides a mapping between the expected meanlevels of descent (stations) and the cervical dilations.

In a non-limiting implementation, as a second step, in order to obtain arange of levels of descent for a given cervical dilation, a secondmathematical equation is derived mapping the standard deviation of thelevel of descent to the level of descent. Any suitable statistical modelmay be used without detracting from the spirit of the invention. Thespecific mathematical equation below was derived by fitting a curve tothe data of the standard deviation of the level of descent v. cervicaldilation shown in table 2 above:

y=0.1632x ²+0.3673x+1.1171

R²=0.7517

In the above equation, y is the standard deviation of the level ofdescent, x is the level of descent and R² is the correlation coefficientsquared which is a measure of how well the fit is between the curvedefined by the mathematical equation and the actual observed data setout in table 2 above. FIG. 7 c of the drawings is a graph depicting amapping between the standard deviations of the levels of descent andlevel of descent on the basis of the above equation as well as theactual observed standard deviation of the level of descent set out intable 2 above.

FIG. 7 b of the drawings is a graph depicting a mapping between expectedranges of levels of descent and cervical dilations on the basis of theabove equations. It is to be appreciated that the values used in theabove equations have been presented for the purpose of illustrationonly. Specific implementations of the invention may make use of valuesdiffering from the above without detracting from the spirit of theinvention.

As a variant, memory unit 220 includes multiple sets of mappings betweenthe cervical dilations and the expected range of levels of descent, eachset of mappings being associated to mothers having certaincharacteristics. In a non-limiting example of implementation, a firstset of mappings is provided for nulliparous women and a second set ofmappings is provided for multiparous women. In another non-limitingexample of implementation, a first set of mappings is provided for womenbetween the ages of 20-30 and a second set of mappings is provided forwomen over 30. It will be readily apparent that other characteristicsmay be used either individually or in combination in order todifferentiate between multiple sets of mappings between the cervicaldilations and the expected range of levels of descent. Suchcharacteristics include, without being limited to mother's weight,height, race and whether or not an epidural was given.

Second Embodiment

In a second specific embodiment, the processing unit 104 is adapted toderive an expected range of levels of descent at least in part on thebasis of a cervical dilation measure, the cervical dilation measurebeing an expected cervical dilation measure. The expected cervicaldilation is the dilation expected to be observed for a patientexperiencing labor. The expected cervical dilation is derived on thebasis of a set of clinical measurements associated with a patient. Anysuitable method for deriving an expected cervical dilation may be used.In a non-limiting implementation, the expected cervical dilation isderived on the basis of the process described in U.S. Pat. No. 6,423,016issued Jul. 23, 2002 to Hamilton, et al. and entitled “System and methodfor evaluating labor progress during childbirth”. The contents of thisdocument are incorporated herein by reference. The above referencedpatent describes, amongst others a method for calculating an expectedcervical dilation on the basis of a set of clinical measurementsincluding a measurement of a previous dilatation of the cervix, acontraction count, a previous level of descent of the child, a previouseffacement measurement of the cervix, an epidural status, and a paritystatus. The clinical measurements are processed to generate an expecteddilatation of the cervix by taking a linear combination of the clinicalmeasurements.

With reference to FIG. 9, the processing unit 104, in accordance with asecond specific embodiment, includes an expected cervical dilationmeasure generator 50, labor progress generation module 52, a memory unit54 and an output control module 56.

Memory unit 54 stores a plurality Of expected ranges of levels ofdescent, each expected range of levels of descent corresponding to arespective cervical dilation. Memory unit 54 can be implemented in amanner similar to that described in connection with memory unit 220 andas such will not be described further here. It will be appreciated thatalthough memory unit 54 has been shown to be an integral part ofprocessing unit 104, memory unit 54 may be an external component toprocessing unit 104 without detracting from the spirit of the invention.

The output control module 56 receives the labor progress information,and optionally the intervention policy information, and generates asignal to be released at output 114 for causing output unit 106 toconvey information to a user. The output control module 56 can beimplemented in a manner similar to that described in connection withoutput control module 240 and as such will not be described furtherhere.

The expected cervical dilation measure generator 50 receives from input110 a set of clinical measurements associated with a patient and isadapted to derive an expected cervical dilation. In a non-limitingimplementation, the expected cervical dilation is derived on the basisof the process described in U.S. Pat. No. 6,423,016 issued Jul. 23, 2002to Hamilton, et al. and entitled “System and method for evaluating laborprogress during childbirth”. The clinical measurements are processed togenerate an expected future dilatation of the cervix by taking a linearcombination of the clinical measurements. The expected cervical dilationmeasure generator 50 is adapted to release the expected cervicaldilation for transmission to the labor progress information generationunit 52.

Optionally, (not shown in the drawing) the expected cervical dilationmeasure generator 50 also releases a signal for causing the expectedcervical dilation to be conveyed to a user in a graphical format.Examples of the manner in which the expected cervical dilation may bedisplayed are described in U.S. Pat. No. 6,423,016.

The labor progress information generation unit 52 receives an observedlevel of descent indicator from input 110 and an expected cervicaldilation measure from the expected cervical dilation measure generator50. The labor progress information generation unit 52 generates dataconveying whether the observed level of descent indicator is within theexpected range of levels of descent corresponding to the expectedcervical dilation. The expected range of levels of descent correspondingto the cervical dilation is derived from information stored in memoryunit 54. The expected range of levels of descent is derived in the samemanner as that described above with reference to labor progressinformation generation unit 210 (shown in FIG. 4) by substituting theobserved cervical dilation measure received at input 110 with theexpected cervical dilation measure received from the expected cervicaldilation measure generator 50.

In a first specific example of implementation, the labor progressgeneration module 52 is adapted to generate data for causing laborprogress information to be conveyed in graphical format.

FIGS. 10 a and 10 b of the drawings show two (2) practical examples oflabor progress information conveyed in graphical format in accordancewith a specific example of implementation. The example depicted in FIG.10 a is associated with a birth with dystocia and the example depictedin FIG. 10 b is associated with a birth where the labor was faster thanaverage.

With reference to FIG. 10 a, there is depicted a first chart 36 showingthe progression of the cervical dilation plotted against time as swellas a range of expected cervical dilations plotted against time for abirth with dystocia. This information is generated by the expectedcervical dilation measure generator 50. In the first chart 36, thehorizontal axis is associated to time and the vertical axis isassociated to cervical dilations. A second chart 38 is also depictedshowing the progression of the level of descent plotted against time aswell as a range of expected levels of descent plotted against time. Therange of expected levels of descent at a given time is derived at leastin part on the basis of the expected cervical dilation associated withthe same given time. In the second chart 38, the horizontal axis isassociated to time and the vertical axis is associated to levels ofdescent. As can be seen in the charts shown in FIG. 10 a, as timeprogresses both the observed dilatation and observed descent arebecoming progressively more unfavorably deviant from the expecteddilation and descent, thereby indicating a growing abnormality in thislabor.

With reference to FIG. 10 b, there is depicted a first chart 30 showingthe progression of the cervical dilation plotted against time as swellas a range of expected cervical dilations plotted against time for afast labor. This information is generated by the expected cervicaldilation measure generator 50. In the first chart 30, the horizontalaxis is associated to time and the vertical axis is associated tocervical dilations. A second chart 34 is also depicted showing theprogression of the level of descent plotted against time as swell as arange of expected levels of descent plotted against time. The range ofexpected levels of descent at a given time is derived at least in parton the basis of the expected cervical dilation associated with the samegiven time. In the second chart 34, the horizontal axis is associated totime and the vertical axis is associated to levels of descent. As can beseen from the charts shown in FIG. 10 b, as time progresses both theobserved dilatation and descent are becoming progressively morefavorably deviant from the expected dilation and descent, therebyindicating that this labor is proceeding faster than most women underthe same circumstances who are experiencing similar labor conditions.

As depicted in FIGS. 10 a and 10 b, the time axis are aligned with oneanother such as to allow a user to readily view the observed cervicaldilation/observed level of descent against the range expected cervicaldilation and the range of levels of descent at a given time.

Advantageously, the information conveyed by the charts in FIGS. 10 a and10 b can be used by a physician or other health care practitioner toassess whether the baby is descending through the birth canal normallyduring labor and whether the cervical dilation is progressing normally.

In an alternative implementation, the labor progress generation module52 is adapted to generate data for causing labor progress information tobe conveyed in text format to a user. Any suitable representation forconveying the observed level of descent indicator in relation to theexpected range of levels of descent may be used.

Optionally, (not shown in FIGS. 10 a and 10 b) a recommendation dataelement is also provided to the user. The recommendation componentprovides an interpretation of the information displayed in charts 30 34or 36 38 as well as a recommended course of action.

It will be appreciated that the specific visual representations shown inFIGS. 10 a and 10 b have been provided for the purpose of illustrationonly and that other visual representations are possible, includingadditional items of information or omitting certain items ofinformation, without detracting from the spirit of the invention.

Non-Limiting Specific Practical Implementations

Those skilled in the art should appreciate that in some embodiments ofthe invention, all or part of the functionality for evaluating laborprogress during childbirth for an obstetrics patient previouslydescribed herein with respect to the apparatus 101, may be implementedas pre-programmed hardware or firmware elements (e.g., applicationspecific integrated circuits (ASICs), electrically erasable programmableread-only memories (EEPROMs), etc.), or other related components.

In other embodiments of the invention, all or part of the functionalitypreviously described herein with respect to the apparatus 101 (shown inFIG. 1) for evaluating labor progress during childbirth may beimplemented as software consisting of a series of instructions forexecution by a computing unit. The series of instructions could bestored on a medium which is fixed, tangible and readable directly by thecomputing unit, (e.g., removable diskette, CD-ROM, ROM, PROM, EPROM,flash memory or fixed disk), or the instructions could be storedremotely but transmittable to the computing unit via a modem or otherinterface device (e.g., a communications adapter) connected to a networkover a transmission medium. The transmission medium may be either atangible medium (e.g., optical or analog communications lines) or amedium implemented using wireless techniques (e.g., microwave, infraredor other transmission schemes).

The apparatus 101 for evaluating labor progress during childbirth may beconfigured as a computing unit 900 of the type depicted in FIG. 11,including a processing unit 901 and a memory 902 connected by acommunication bus 904. The memory 902 includes data 906 and programinstructions 908. The processing unit 901 is adapted to process the data906 and the program instructions 908 in order to implement the methoddescribed in the specification and depicted in the drawings. Thecomputing unit 900 may also comprise a number of interfaces 910, and 914for receiving or sending data elements to external devices. For example,interface 910 receives signals from user interface 102 as described withrespect to FIG. 1, and as such is used for receiving information dataelements associated to an obstetrics patient. The processing unit 901 isoperative for processing the information data elements to generate laborprogress information associated to the obstetrics patient, the laborprogress information conveying whether the level of descent indicator iswithin an expected range of levels of descent for a given cervicaldilation measure. Optionally, the processing unit 901 is operative forgenerating intervention policy information when the level of descentindicator is outside the expected range of levels of descent. Interface914 is for releasing a signal conveying the labor progress information,an optionally the intervention policy information. The released signalis transmitted to output unit 106 (FIG. 1), such that output unit 106may convey the labor progress information generated by processing unit901 to a health care professional.

In a specific example of implementation, the memory 902 includes aprogram element within the program instructions 908, for execution bythe computing unit 900. Once the processing unit 901 has derived laborprogress information associated to the obstetrics patient, the programelement is operative cause the labor progress information to be conveyedto a user on an output unit. As described above, in specific embodiment,the output unit 106 can include either one of a display screen or aprinter.

In a specific implementation, the data portion 906 of the memory 902includes data conveying a plurality of expected ranges of levels ofdescent, each expected range of levels of descent corresponding to arespective cervical dilation.

It will be appreciated that the system for monitoring an obstetricspatient may also be of a distributed nature where the set of informationdata elements associated to an obstetrics patient is collected at onelocation or more locations and transmitted over a network to a serverunit implementing the method described above. The server unit may thentransmits a signal for causing an output unit to convey information tothe user. The output unit may be located in the same location where theset of information data elements is being obtained or in the samelocation as the server unit or in yet another location. FIG. 12illustrates a network-based client-server system 1000 for monitoring anobstetrics patient associated to one or more obstetrics patients. Theclient-server system 1000 includes a plurality of client systems 1002,1004, 1006 and 1008 connected to a server system 1010 through network1012. The communication links 1014 between the client systems 1002,1004, 1006 and 1008 and the server system 1010 can be metallicconductors, optical fibres or wireless, without departing from thespirit of the invention. The network 1012 may be any suitable networkincluding but not limited to a global public network such as theInternet, a private network and a wireless network. The server 1010 maybe adapted to process and issue signals concurrently using suitablemethods known in the computer related arts.

The server system 1010 includes a program element 1016 for execution bya CPU. Program element 1016 implements similar functionality as programinstructions 908 (shown in FIG. 11) and includes the necessarynetworking functionality to allow the server system 1010 to communicatewith the client systems 1002, 1004, 1006 and 1008 over network 1012. Ina non-limiting example of implementation, program element 1016 includesa number of program element components, each program element componentsimplementing a respective portion of the functionality of apparatus 101(shown in FIG. 1).

FIG. 13 shows a non-limiting example of the architecture of an exampleof implementation of program element 1016 at the server system:

-   -   1. The first program element component 1100 is executed on        server system 1010 and is for receiving a set of information        data elements associated to an obstetrics patient. In a specific        implementation, the set of information data elements includes a        cervical dilation measure and a level of descent indicator.    -   2. The second program element component 1102 is executed on        server system 1010 and is for processing the set of information        data elements to generate labor progress information associated        to the obstetrics patient. The labor progress information        ranking data element conveys whether the level of descent        indicator is within an expected range of levels of descent, the        expected range of levels of descent corresponding to the        cervical dilation measure.    -   3. The third program element component 1104 is executed on        server system 1010 and is for sending messages to a client        system (1002, 1004, 1006 or 1008) for causing the client system        to convey the labor progress information.    -   4. The fourth program element component 1106 is executed on the        client system and is for receiving a message from the server        system 1010 for conveying the labor progress information to a        user.

Those skilled in the art should further appreciate that the programinstructions may be written in a number of programming languages for usewith many computer architectures or operating systems. For example, someembodiments may be implemented in a procedural programming language(e.g., “C”) or an object oriented programming language (e.g., “C++” or“JAVA”).

Although the present invention has been described in considerable detailwith reference to certain preferred embodiments thereof, variations andrefinements are possible without departing from the spirit of theinvention. Therefore, the scope of the invention should be limited onlyby the appended claims and their equivalents.

1. A method for monitoring an obstetrics patient during childbirth, saidmethod comprising: a) receiving a set of information data elementsassociated with the obstetrics patient, the set of information dataelements conveying: i. a cervical dilation measure; and ii. an observedlevel of descent indicator; b) using a processing unit programmed withsoftware, deriving an expected range of levels of descent at least inpart by processing the cervical dilation measure, the derived expectedrange of levels of descent conveying levels of descent expected whenchildbirth is progressing normally; and c) causing labor progressinformation associated with the obstetrics patient to be displayed on adisplay device, the labor progress information conveying whether theobserved level of descent indicator lies within the derived expectedrange of levels of descent.
 2. A method as defined in claim 1, whereinthe labor progress information conveys the observed level of descentindicator in relation to the expected range of levels of descent.
 3. Amethod as defined in claim 2, wherein the cervical dilation measure isan expected cervical dilation measure associated with the obstetricspatient.
 4. A method as defined in claim 3, wherein said methodcomprises processing the observed level of descent indicator todetermine whether it lies within the expected range of levels ofdescent.
 5. A method as defined in claim 1, wherein the labor progressinformation is caused to be conveyed in graphical format.
 6. A method asdefined in claim 5, wherein the graphical format includes a chart havinga horizontal axis and a vertical axis, the horizontal axis beingassociated with time and the vertical axis being associated with levelsof descent.
 7. A method as defined in claim 2, wherein the cervicaldilation measure is an observed cervical dilation measure associatedwith the obstetrics patient.
 8. A method as defined in claim 7, whereinsaid method further comprises: providing a plurality of expected rangesof levels of descent, each expected range of levels of descentcorresponding to a respective cervical dilation; and causing theplurality of expected ranges of levels of descent to be conveyed to auser.
 9. A method as defined in claim 8, wherein the plurality ofexpected ranges of levels of descent is derived from data associatedwith a reference population.
 10. A method as defined in claim 7, whereinthe labor progress information is caused to be conveyed in graphicalformat.
 11. A method as defined in claim 10, wherein the graphicalformat includes a chart having a horizontal axis and a vertical axis,the horizontal axis being associated with cervical dilation measures andthe vertical axis being associated with levels of descent.
 12. A methodas defined in claim 1, said method further comprising: processing theobserved level of descent indicator to determine whether it lies withinthe derived expected range of levels of descent; generating interventionpolicy information when the observed level of descent indicator isoutside the expected range of levels of descent; and causing theintervention policy information to be provided to a user.
 13. A methodas defined in claim 1, wherein the labor progress information is causedto be conveyed in text format.
 14. A method as defined in claim 1,wherein the display device is selected from the set consisting of adisplay screen and a printer.
 15. A computer program product, tangiblystored on one or more tangible computer readable storage media, formonitoring an obstetrics patient during childbirth, the program productcomprising instructions that, when executed, cause a programmable systemincluding at least one programmable processor to perform operations, theoperations comprising: i. receiving a set of information data elementsassociated with the obstetrics patient, the set of information dataelements including: (1) a cervical dilation measure; and (2) an observedlevel of descent indicator; ii. deriving an expected range of levels ofdescent at least in part by processing the cervical dilation measure,the derived expected range of levels of descent conveying levels ofdescent expected when childbirth is progressing normally; iii. causinglabor progress information associated with the obstetrics patient to bedisplayed on a display device, the labor progress information conveyingwhether the observed level of descent indicator lies within the derivedexpected range of levels of descent.
 16. A computer program product asdefined in claim 15, wherein the labor progress information conveys theobserved level of descent indicator in relation to the expected range oflevels of descent.
 17. A computer program product as defined in claim16, wherein the cervical dilation measure is an expected cervicaldilation measure associated with the obstetrics patient.
 18. A computerprogram product as defined in claim 17, wherein said operations furthercomprise processing the observed level of descent indicator to determinewhether it lies within the expected range of levels of descent.
 19. Acomputer program product as defined in claim 15, wherein the laborprogress information is caused to be conveyed in graphical format.
 20. Acomputer program product as defined in claim 19, wherein the graphicalformat includes a chart having a horizontal axis and a vertical axis,the horizontal axis being associated with time and the vertical axisbeing associated with levels of descent.
 21. A computer program productas defined in claim 15, wherein the cervical dilation measure is anobserved cervical dilation measure associated with the obstetricspatient.
 22. A computer program product as defined in claim 21, whereinsaid operations further comprise: providing a plurality of ranges oflevels of descent, each range of levels of descent corresponding to arespective cervical dilation; and causing the plurality of ranges oflevels of descent to be conveyed to a user.
 23. A computer programproduct as defined in claim 22, wherein the plurality of ranges oflevels of descent conveys a reference band of expected levels of descentderived from data associated with a reference population.
 24. A computerreadable storage medium as defined in claim 21, wherein the laborprogress information is caused to be provided in graphical format.
 25. Acomputer readable storage medium as defined in claim 24, wherein thegraphical format includes a chart having a horizontal axis and avertical axis, the horizontal axis being associated with cervicaldilation measures and the vertical axis being associated with levels ofdescent.
 26. A computer readable storage medium as defined in claim 15,wherein said operations further comprise: a) processing the observedlevel of descent indicator to determine whether it lies within thederived expected range of levels of descent; b) generating interventionpolicy information when the observed level of descent indicator isoutside the expected range of levels of descent; and c) causing theintervention policy information to be provided to a user.
 27. A computerreadable storage medium as defined in claim 15, wherein the laborprogress information is caused to be provided in text format.
 28. Acomputer readable storage medium as defined in claim 15, wherein thedisplay device is selected from the set consisting of a display screenand a printer.
 29. A system for monitoring an obstetrics patient duringchildbirth, comprising: a) an interface for receiving a set ofinformation data elements associated with the obstetrics patient, theset of information data elements conveying: i. a cervical dilationmeasure; and ii. an observed level of descent indicator; b) an apparatusincluding: i. an input in communication with said interface forreceiving the set of information data elements; ii. a processing unit incommunication with said input, said processing unit being programmedfor: (1) deriving an expected range of levels of descent at least inpart by processing the cervical dilation measure, the derived expectedrange of levels of descent conveying levels of descent expected whenchildbirth is progressing normally ; (2) generating a signal for causinglabor progress information associated with the obstetrics patient to bedisplayed on a display device, the labor progress information conveyingwhether the observed level of descent indicator lies within the derivedexpected range of levels of descent.
 30. A system as defined in claim29, wherein the interface is selected from a keyboard, a pointingdevice, a touch sensitive screen, a data input device and a voicerecognition unit.
 31. A system as defined in claim 29, wherein saiddisplay device is either one of a display screen and a printing device.32. A system as defined in claim 29, wherein the cervical dilationmeasure is an expected cervical dilation measure associated with theobstetrics patient.
 33. A system as defined in claim 32, wherein saidprocessing unit is programmed for processing the observed level ofdescent indicator to determine whether it lies within the expected rangeof levels of descent.
 34. A system as defined in claim 29, wherein thecervical dilation measure is an observed cervical dilation measureassociated with the obstetrics patient.
 35. A method for monitoring anobstetrics patient during childbirth, said method comprising: a)obtaining a set of information data elements associated with theobstetrics patient, the set of information data elements conveying: i. acervical dilation measure; and ii. an observed level of descentindicator; b) transmitting the set of information data elements to aremote computing apparatus, the remote computing apparatus beingprogrammed for: i. deriving an expected range of levels of descent atleast in part by processing the cervical dilation measure, the derivedexpected range of levels of descent conveying levels of descent expectedwhen childbirth is progressing normally; c) receiving data from theremote computing apparatus, the data conveying labor progressinformation associated with the obstetrics patient, the labor progressinformation conveying whether the observed level of descent indicatorlies within the derived expected range of levels of descent; and d)causing the labor progress information to be provided to a user using adisplay device.